MEDICARE: AYMAN ALIBRAHIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	ME86742	FL

General Provider Information

NPI Number	:	1063469104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYMAN ALIBRAHIM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 127
Second Line	:
City	:	LECANTO
State	:	FL
Zip	:	34460-0127
Country	:	US
Telephone Number	:	352-746-3336
Fax Number	:	352-746-3305

Provider Business Practice Location Address
First Line	:	508 N LECANTO HWY
Second Line	:
City	:	LECANTO
State	:	FL
Zip	:	34461-8547
Country	:	US
Telephone Number	:	352-746-3336
Fax Number	:	352-746-3305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	04/23/2009

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